I think it’s safe to say that my current roles will be some of my last in the NHS, having started as a junior doctor in 1983. When I was appointed as a chair of University Hospitals of Derby and Burton, where I was a consultant and medical director for 15 years, there was an enormous sense of pride, but also that feeling of responsibility I’ve had throughout my career, certainly to our patients, but also to our staff.

I was fortunate to have been part of NHSI when the “NHS Women on Boards 50:50 by 2020” was launched in 2016. Four years on “Action for Equality: the time is now”, published today by the NHS Confederation’s Health and Care Women Leaders Network, describes the progress boards have made since then to increase diversity in terms of women and ethnic minority representation. I believe this is crucial to good decision making, representing communities, patients and staff and has led me to reflect on some of the things that have enabled my career and role on a number of boards.

Since 2016, progress has been made in some areas, but in others the change that we had hoped for has been slow. It has not been without trying. Achieving 50:50 on the Board at UHDB this year was a proud moment. A clear sign to the communities we serve that diversity matters, although I am aware that we have far more to do, with respect to other diversity.

There have been many women, and men of course, who have helped me in my career. But as an unspoken commitment to those senior women that supported me, I’ve always felt I needed to do what they did and support the next generation. Certainly those that went before me had it harder than I did, and I very much hope those who come after me will find the NHS as open to supporting their progress as I did.

Just over a decade after I started, I was appointed as a consultant physician. In the intervening years as a senior registrar I started to get involved in making changes to patient pathways. At this time I started a new family, which then became two, on both occasions taking maternity leave, but rapidly resuming full-time work.

But within months of becoming a consultant I realised that for me it was not enough. I found that by saying “yes” to the offers of responsibility that came along I could start to influence things. Support and encouragement from my colleagues and hospital leaders was critical and my advice to my younger self would be to seek this more directly.

It was not long before I was asked to become a clinical director. It was a massive challenge and the learning curve was steep. I made many mistakes, but I discovered that talking with people, taking their ideas and concerns on board, and maintaining a focus on patients, led to remarkable results. I was fortunate to work with brilliant people and I looked to them as role models. If other leaders were positive about my contribution it encouraged me to keep going.

A merger opened up the opportunity of a medical director role, which I seized and stayed in for seven years. My female CEO assigned me a coach—who I continued to see for a further 18 years. A regional role followed and my CEO, again a woman, was supportive and encouraging and gave me the chance to take on some national roles, but I was conscious that women were frequently outnumbered by men.

I’m now back at my local Trust, still learning of course, but when I reflect on a long career, I feel that by saying yes, being helpful, believing in myself when it was not easy to do so, finding inspirational people as role models, taking development opportunities and having a coach, have all contributed. We’ve still got a journey ahead of us but I’m confident having seen the next generation of women in the NHS they will continue the work started many years ago by those who supported me.

Kathy McLean is Chair of University Hospitals of Derby and Burton and a Non-Executive Director at Barts Health NHS Trust. Kathy McLean was previously Medical Director and Chief Operating Officer at NHS Improvement.

Competing interests: None declared